Member Services Specialist — Remote/Hybrid Eligible

Group Health Cooperative of South Central Wisconsi; Madison (WI); Hybrid; USD 32,000 - 46,000; Full time

Job summary

The Group Health Cooperative of South Central Wisconsin is seeking a responsible Member Services Representative in Wisconsin. This full-time role handles member and provider inquiries about benefits, claims, referrals, and clinic services, and supports complaint resolution with careful documentation and follow-up.

The position requires at least two years of public-facing experience, excellent communication, and the ability to work with diverse populations while maintaining confidentiality and

Qualifications

• High school education or equivalent required.
• Minimum of two years' experience in a responsible public contact position.
• Knowledge of HIPAA requirements.
• Excellent verbal communication and listening skills.
• Excellent customer service skills and ability to maintain confidentiality.
• Ability to use Microsoft Office and learn EPIC.

Responsibilities

• Respond to members and providers benefits, claims, referral and clinic services inquiries.
• Assist members with the resolution of complaints including interviewing complainants, investigation of the complaint and reporting details to internal staff.
• Maintain departmental data entry and records as needed.
• Operate under supervision of the Member Services Manager and uphold organizational policies.

Skills

Verbal communication

Customer service

Confidentiality

Multitasking

Education

High school diploma or equivalent

Tools

Microsoft Office

EPIC

Email systems

Job description

The Group Health Cooperative of South Central Wisconsin is seeking a responsible Member Services Representative in Wisconsin. This full-time role handles member and provider inquiries about benefits, claims, referrals, and clinic services, and supports complaint resolution with careful documentation and follow-up.

The position requires at least two years of public-facing experience, excellent communication, and the ability to work with diverse populations while maintaining confidentiality and